By Brian Allen, VP of Government Affairs, Mitchell
There’s no question that healthcare is at the forefront of many conversations as we head into 2020 and the next presidential election. From discussions of restructuring the healthcare system to combatting rising costs to continuing the fight against the opioid crisis, the topic is pervasive.
A recent Gallup poll highlighted how important the topic is to Americans. The “availability and affordability of healthcare” topped a list of fifteen important concerns for Americans, with 55 percent of respondents rating their worry about this issue at a “great deal” and 25 percent saying they worry about it a “fair amount”.
With this topic sure to continue to dominate discussion throughout 2020, what should the workers’ compensation industry expect?
Discussions on Healthcare Costs and Drug Pricing
When issues such as high drug prices impact the general healthcare system, they also affect the workers’ compensation industry. In 2019, several states looked at legislation related to cost transparency and we expect that to continue into 2020. California and Texas have both passed legislation requiring drug manufacturers to justify price increases that exceed a specific threshold. Several other states have passed bills requiring drug price transparency at the pharmacy benefit manager level. Utah will consider a bill in its 2020 session that would require drug price transparency throughout the supply chain.
Beyond the federal discussion for the presidential election, we expect states to continue to push reform where they are able and tackle issues related to the cost and delivery of healthcare. While the federal government continues to debate these issues, states are looking at implementing ACA-like reforms. In a few states, legislatures are considering a single-payer model that could include medical care related to workplace injuries. Such a move would be a dramatic shift for workers’ compensation in those states. If these reforms do pass, we will see how it could impact the claims continuum.
The opioid crisis continues to impact communities across the U.S. According to the CDC, “opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths).” The main driver of these deaths are synthetic opioids. Prescription opioid overdose deaths without other synthetic narcotics have actually decreased since 2011, but those involving synthetic opioids have skyrocketed.
However, prescription opioids are still a concern and controlling prescribing of opioids is at the forefront of state policy. In 2019, several states passed opioid prescribing limits or modified their current opioid limit laws. Texas implemented a 10-day limit on opioids for acute pain. Montana and Wyoming passed laws limiting opioids to 5 days for acute pain. This will likely continue into 2020 as states learn more about how their current guidelines are working and as they adjust their strategies.
The current landscape of marijuana legalization is becoming increasingly complex. Several states had bills related to marijuana running in 2019, with Illinois legalizing (PDF) recreational marijuana. The U.S. House also passed the SAFE Banking Act, which would open up financial institutes to provide services to marijuana-related businesses. If this bill passes the Senate and is signed into law, it would be a major shift for the federal government and could possibly open the door for further legalization and more general acceptance of reimbursement by insurers.
One bill that is likely to be of interest throughout the presidential election is S2227, supported by several Democratic presidential candidates. This bill would deschedule marijuana and allow it to be taxed like tobacco. It would also open the door for states to regulate the drug legally within their jurisdictions.
From a clinical point of view, there are still very few clinical studies that show the potential side effects or benefits of marijuana for medicinal use. This will become extremely important if any of these bills move forward on the federal level. Recent alarms set off by various health agencies around the vaping of THC infused products is giving some policy makers pause on further legalization efforts and what the health implications might be. However, constituent support for legalization will likely be a motivating factor as Congress considers changing the status of marijuana at the federal level.
Read our last Leaders Speak article to learn more about recent studies and updates related to medical marijuana.
While Congress works its ways through the legislative process on legalization, at least ten states are considering voter initiatives for 2020 that would legalize marijuana medically or recreationally. If all of those initiatives pass, Kansas would be the lone state without any legalized form of marijuana.
2020 Election and Workers’ Compensation
2020 will be an interesting year politically, with sharp divisions on a number of issues. What is clear is that the upcoming year will likely usher in more focus on issues like healthcare costs, opioids and medical marijuana. With both legislatures and the public interested in health care reform and the opioid epidemic, change is sure to come. We will keep you posted on all the outcomes along the way. We’ll see you in the new decade!
About Brian Allen
Brian Allen is a nationally recognized policy expert for workers’ compensation and insurance issues across the country. Allen currently serves as Vice President of Government Affairs for the Mitchell Pharmacy Solutions team. In this role, Allen provides insight into new legislation and regulations in the industry, authors articles and blogs for industry publications and frequently speaks at conferences across the country.
Headquartered in San Diego, California, Mitchell International, Inc. delivers smart technology solutions that simplify and accelerate claims handling and repair processes, driving more accurate, consistent and cost-effective resolutions. Mitchell integrates deep industry expertise into its workflow solutions, providing unparalleled access to data, advanced analytics and decision support tools. Mitchell’s comprehensive solution portfolio and robust SaaS infrastructure connect its customers in ways that enable tens of millions of electronic transactions to be processed each month for more than 300 insurance companies, over 30,000 collision repair facilities and countless other Property & Casualty industry supply partners across the Americas and Europe. For more information, please visit mitchell.com.
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